Heart Tones and Assessment

By: Diana Blum MSNMetropolitan Community

College

OBJECTIVE 1

EVENTS THAT CREATE NORMAL SOUND

Cardiac Cycle

Contraction and relaxation of the heart: lub dub or 1 heart beat

Diastole: ventricles at rest and filling up with blood coming from the atria (Dub)

Systole: Once the Ventricle is filled with blood and the electrical impulse has reached the terminal fibers of the conduction system, the Ventricle contract and eject blood into the pulmonary artery from the RV and into the aorta from the LV (Lub)

Autonomic Nervous System

Built in control center of the body Regulates functions not under conscious control Blood vessels innervated by sympathetic system

– Fight or flight

Nerve endings are adrenergic and nuerotransmitter is norepinephrine

– Increases HR and BP Parasympathetic is responsible for rest and digest

– Cholinergics are the nerve endings and acetylcholine is the neurotransmitter

Decreases HR and BP Parasympathetic and sympathetic innervates

heart4

Video

http://www.blinkx.com/video/heart-system/ALAjmSD19aWwdVJNyeOLjA

OBJECTIVE 2

ABNORMAL HEART TONES

Heart Tones– Murmur: Produced by turbulent sounds across valves– Gallop: extra heart beat– Click: sounds like a clicking sound from a valve

that is metal– Rub: inflamed pericardium-best heart along left

sternal border– S3 murmur: sounds like “Kentucky”– S4 murmur: sounds like “Mississippi”

http://www.blaufuss.org/ http://www.med.ucla.edu/wilkes/Rubintro.htm

Innocent Heart Murmurs Normal heart murmurs Benign heart murmurs Functional heart murmurs Physiologic heart murmurs Still’s murmurs Flow murmurs

Pathologic heart murmurs – Related to valve problems and produce

symptoms

Evaluation of murmurs When evaluating a heart murmur, your doctor

pays attention to many things, such as:– How faint or loud the sound is. Your doctor will

grade the murmur on a scale of 1 to 6 (1 is very faint and 6 is very loud).

– When the sound occurs in the cycle of the heartbeat.

– Exactly where the sound is heard in the chest and whether it also can be heard in the neck or back.

– Whether the sound has a high, medium, or low pitch.

– How long the sound lasts. – How breathing, physical activity, or change of

body position affects the sound.

OBJECTIVE 3

SYSTOLIC VS DIASTOLIC MURMURS

systolic murmur

is heard when the heart is squeezing and pumping blood out of the heart.

diastolic murmur

is heard when the heart is relaxing and filling with blood.

often are a sign of a heart defect or heart disease, and further checking is likely needed.

Continous Murmur

is heard during the entire heartbeat. These murmurs often are a sign of a heart defect or heart disease, and further checking is likely needed.

Inspection and palpation

http://www.youtube.com/watch?v=WbBIHRPlyj8&feature=related

USE MY NURSING LAB also

OBJECTIVE 4

DEMONSTRATION